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Question:

Visc-sens 14 referred pain regions - cholecystitis

Response:

At the top left you can see the abdominal organs and the segmental vertebral levels where visceral sensory stimuli (pain) originate from that organ. At the top right is a dermatome card. Click the image to enlarge it. You can use these segmental representations and the dermatomes to answer the question below. Below, marked with letters A to D, are 4 patterns of pain that may occur. Red always indicates visceral pain (deep, in the middle line, not easily localizable, accompanied by autonomic symptoms), and purple 'referred pain' (occurring in dermatomes, often there is also hypersensitivity to light stimuli such as e.g. caressing the skin). Which pain pattern best describes acute cholecystitis?  

AnswersYour AnswerCorrect
A
B
C
D
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Question:

Visc-sens 20

Response:

The figure shows the pathways by which pain stimuli in the pelvic and perineum area run. You can use this when answering the next question. What kind of anesthesia during delivery can cause the mother to still feel the contractions, but not the pain of cervical dilatation and of stretching of the vagina and pelvic floor?

AnswersYour AnswerCorrect
A regional block at the height of T12.
A pudendal nerve block.
An epidural block at the level of the sacral nerves S2-S4.
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Question:

Visc-sens 22

Response:

A 12 year old boy reports diffuse, poorly localizable, abdominal pain around the navel, such as the red area indicated in picture A. In addition, the area marked purple in picture A is painful to light touch. The GP considers an early acute appendicitis, but because the boy is only moderately ill, it is decided to adopt a conservative strategy. Two days later the boy comes for another consultation. On physical examination, unlike during the first consultation, the boy can now clearly indicate the location of the strongest pain, in the right lower abdomen, see the orange spot in image B. Of course, the general presentation, fever and lab are also considered, but what development of the disease process is likely, judging only from the development of the pain presentation?

AnswersYour AnswerCorrect
The inflammatory process has become encapsulated, limiting the pain to a smaller area.
The inflammatory process has spread around the area of ​​the appendix and reached the anterior abdominal wall.
The inflammatory process has expanded, affecting the visceral peritoneum around the appendix and caecum.
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Question:

Visc-sens 21

Response:

What treatment (s) could provide palliative pain relief for uncontrollable pain associated with unresectable pancreatic cancer? Multiple answers are correct.

AnswersYour AnswerCorrect
A coeliac plexus block. 
Severing the sympathetic trunk at the level of L1, just above the pancreas.
Severing the anterior and posterior vagal trunks near the oesophageal hiatus.
Splanchnicectomy: severing the thoracic splanchnic nerves (splanchnicus major, minor, imus nerves).
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Question:

Visc-sens 15 referred pain regions - kidney stone

Response:

At the top left you can see the abdominal organs and the segmental vertebral levels where visceral sensory stimuli (pain) originate from that organ. At the top right is a dermatome card. Click the image to enlarge it. You can use these segmental representations and the dermatomes to answer the question below. Below, marked with letters A to D, are 4 patterns of pain that may occur. Red always indicates visceral pain (deep, in the middle line, not easily localizable, accompanied by autonomic symptoms), and purple 'referred pain' (occurring in dermatomes, often there is also hypersensitivity to light stimuli such as e.g. caressing the skin). Which pain pattern best describes kidney stones?  

AnswersYour AnswerCorrect
A
B
C
D